1. Was insulin shock therapy a viable clinical treatment?
the first successful treatments for schizophrenia (dementia praecox) at a time when that diagnosis was associated with persistent psychosis, prolonged asylum incarceration, aggressive outbursts, suicide, and dementia (marked by memory disorders, personality changes and impaired listening). The treatments were unpleasant and dangerous because they were given without anesthesia. The ICT mortality rate varied from 1% to 10% of patients treated. Prolonged coma, in which the patient did not respond to the administration of glucose, was a constant threat. Though ICT may have been considered "the last straw of hope" back up until the 1950s, due to morality and mortality issues, ICT is no longer practiced in the West but sometimes there are news of practices in China and other previous Soviet Union countries.
2. Was John Nash an unusual case, or do you think that many schizophrenic patients can be taught to function in society with without medication?
John Nash was a rare case especially because not many people are lucky enough to have recovered from schizophrenia. Many people were imprisoned in asylums to be treated with medication such as ICT for years, but Nash was lucky enough to have stayed in the horrible facilities for just six months. He also recovered temporarily to a perfectly ordinary state though real recovery did take years to happen. It would be difficult to bring others who are suffering from schizophrenia to attempt to fit into the norms of society, but it would be worth a try especially if there is a person as strong minded as Nash.
3. What are the dangers and/or advantages of this type of treatment (re: insulin shock therapy)?
The use of insulin in schizophrenia therapy was extremely inhumane because anesthesia was not put to practice before the therapy took place. Therefore shock cause the mortality rate of patient to peak the charts. The therapy does, if successful, give the most direct effect, but still the morality and mortality issue of this type of treatment does not match its worthiness.
4. What is the difference between the treatment of schizophrenia in 1960-1970 and today?
The first "modern" antipsychotic drug, chlorpromazine, was introduced for the treatment of schizophrenia about fifty years ago. Over the next two decades at least a dozen more antipsychotic drugs were introduced. While these drugs offered unprecedented hope and diminished suffering for countless mentally ill people and substantially contributed to the "deinstitutionalization" of mentally ill people from long-term hospitalization in the 1960's and 70's, the "neuroleptic" drugs had serious limitations. First, their effectiveness was limited to the "positive symptoms" of schizophrenia, such as hallucinations, delusions, and grossly disorganized thinking. The "negative symptoms" of schizophrenia, such as social withdrawal, paucity of thought, diminished motivation and energy, and blunted emotional expression, were relatively untouched by these treatments. Second, the neuroleptics caused serious neurological side effects, sometimes permanently, in people on these drugs. All of the drugs are thought to exert their effects through an ability to block post-synaptic dopamine receptors.
In 1990 the first "atypical" antipsychotic drug, clozapine, was introduced for the treatment of schizophrenia. The new generation antipsychotic drugs represented a major advance in the treatment of schizophrenia to many people who did not respond to the older drugs. Many people's lives have improved immeasurably or have even been saved altogether thanks to these drugs. However, clinicians have had little evidence to guide drug selection for a given patient. Basic questions about which drug to use, and in what circumstances, are yet to be answered.
5. What are the various types of schizophrenia? Which would you consider the worst case to have? The least worst? Explain why for each.
Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations but relatively normal intellectual functioning and expression of affect. The delusions can often be about being persecuted unfairly or being some other person who is famous. People with paranoid-type schizophrenia can exhibit anger, aloofness, anxiety, and argumentativeness.
Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh at the changing color of a traffic light or at something not closely related to what they are saying or doing. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
Catatonic-type schizophrenia is characterized by disturbances of movement. People with catatonic-type schizophrenia may keep themselves completely immobile or move all over the place. They may not say anything for hours, or they may repeat anything you say or do senselessly. Either way, the behavior is putting these people at high risk because it impairs their ability to take care of themselves
Undifferentiated-type schizophrenia is characterized by some symptoms seen in all of the above types but not enough of any one of them to define it as another particular type of schizophrenia.
Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no positive symptoms (delusions, hallucinations, disorganized speech or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
Undifferentiated-type schizophrenia arguably seems to be the worst case of schizophrenia to have simply because it may be characterized by any of the three other main types of schizophrenia (paranoid-tye, disorganized-type, and the catatonic-type). Also because it is hard to define the exact symptom, it would be harder to treat and know what to expect.
Residual-type schizophrenia on the other hand, seems to be the least worst case to suffer from because there are no positive symptoms though it sounds like it may be the "long term" one out of the five. The rest of the types seem extreme and may possibly lead to dents in social and physical life because it would be very difficult to fit into society.
6. What treatments are being pioneered today for schizophrenia?
ICT is no longer practiced, but ECT is now widely prescribed for the relief of severe psychiatric illnesses. We have learned, to our disappointment, that none of the medications used for the treatment of psychiatric illnesses provide "cures." A percentage of patients quickly become "therapy resistant." The medications fail to control their psychosis, and it is at such times that ECT is widely employed today.
the first successful treatments for schizophrenia (dementia praecox) at a time when that diagnosis was associated with persistent psychosis, prolonged asylum incarceration, aggressive outbursts, suicide, and dementia (marked by memory disorders, personality changes and impaired listening). The treatments were unpleasant and dangerous because they were given without anesthesia. The ICT mortality rate varied from 1% to 10% of patients treated. Prolonged coma, in which the patient did not respond to the administration of glucose, was a constant threat. Though ICT may have been considered "the last straw of hope" back up until the 1950s, due to morality and mortality issues, ICT is no longer practiced in the West but sometimes there are news of practices in China and other previous Soviet Union countries.
2. Was John Nash an unusual case, or do you think that many schizophrenic patients can be taught to function in society with without medication?
John Nash was a rare case especially because not many people are lucky enough to have recovered from schizophrenia. Many people were imprisoned in asylums to be treated with medication such as ICT for years, but Nash was lucky enough to have stayed in the horrible facilities for just six months. He also recovered temporarily to a perfectly ordinary state though real recovery did take years to happen. It would be difficult to bring others who are suffering from schizophrenia to attempt to fit into the norms of society, but it would be worth a try especially if there is a person as strong minded as Nash.
3. What are the dangers and/or advantages of this type of treatment (re: insulin shock therapy)?
The use of insulin in schizophrenia therapy was extremely inhumane because anesthesia was not put to practice before the therapy took place. Therefore shock cause the mortality rate of patient to peak the charts. The therapy does, if successful, give the most direct effect, but still the morality and mortality issue of this type of treatment does not match its worthiness.
4. What is the difference between the treatment of schizophrenia in 1960-1970 and today?
The first "modern" antipsychotic drug, chlorpromazine, was introduced for the treatment of schizophrenia about fifty years ago. Over the next two decades at least a dozen more antipsychotic drugs were introduced. While these drugs offered unprecedented hope and diminished suffering for countless mentally ill people and substantially contributed to the "deinstitutionalization" of mentally ill people from long-term hospitalization in the 1960's and 70's, the "neuroleptic" drugs had serious limitations. First, their effectiveness was limited to the "positive symptoms" of schizophrenia, such as hallucinations, delusions, and grossly disorganized thinking. The "negative symptoms" of schizophrenia, such as social withdrawal, paucity of thought, diminished motivation and energy, and blunted emotional expression, were relatively untouched by these treatments. Second, the neuroleptics caused serious neurological side effects, sometimes permanently, in people on these drugs. All of the drugs are thought to exert their effects through an ability to block post-synaptic dopamine receptors.
In 1990 the first "atypical" antipsychotic drug, clozapine, was introduced for the treatment of schizophrenia. The new generation antipsychotic drugs represented a major advance in the treatment of schizophrenia to many people who did not respond to the older drugs. Many people's lives have improved immeasurably or have even been saved altogether thanks to these drugs. However, clinicians have had little evidence to guide drug selection for a given patient. Basic questions about which drug to use, and in what circumstances, are yet to be answered.
5. What are the various types of schizophrenia? Which would you consider the worst case to have? The least worst? Explain why for each.
- Paranoid-type schizophrenia is characterized by delusions and auditory hallucinations but relatively normal intellectual functioning and expression of affect. The delusions can often be about being persecuted unfairly or being some other person who is famous. People with paranoid-type schizophrenia can exhibit anger, aloofness, anxiety, and argumentativeness.
- Disorganized-type schizophrenia is characterized by speech and behavior that are disorganized or difficult to understand, and flattening or inappropriate emotions. People with disorganized-type schizophrenia may laugh at the changing color of a traffic light or at something not closely related to what they are saying or doing. Their disorganized behavior may disrupt normal activities, such as showering, dressing, and preparing meals.
- Catatonic-type schizophrenia is characterized by disturbances of movement. People with catatonic-type schizophrenia may keep themselves completely immobile or move all over the place. They may not say anything for hours, or they may repeat anything you say or do senselessly. Either way, the behavior is putting these people at high risk because it impairs their ability to take care of themselves
- Undifferentiated-type schizophrenia is characterized by some symptoms seen in all of the above types but not enough of any one of them to define it as another particular type of schizophrenia.
- Residual-type schizophrenia is characterized by a past history of at least one episode of schizophrenia, but the person currently has no positive symptoms (delusions, hallucinations, disorganized speech or behavior). It may represent a transition between a full-blown episode and complete remission, or it may continue for years without any further psychotic episodes.
Undifferentiated-type schizophrenia arguably seems to be the worst case of schizophrenia to have simply because it may be characterized by any of the three other main types of schizophrenia (paranoid-tye, disorganized-type, and the catatonic-type). Also because it is hard to define the exact symptom, it would be harder to treat and know what to expect.Residual-type schizophrenia on the other hand, seems to be the least worst case to suffer from because there are no positive symptoms though it sounds like it may be the "long term" one out of the five. The rest of the types seem extreme and may possibly lead to dents in social and physical life because it would be very difficult to fit into society.
6. What treatments are being pioneered today for schizophrenia?
ICT is no longer practiced, but ECT is now widely prescribed for the relief of severe psychiatric illnesses. We have learned, to our disappointment, that none of the medications used for the treatment of psychiatric illnesses provide "cures." A percentage of patients quickly become "therapy resistant." The medications fail to control their psychosis, and it is at such times that ECT is widely employed today.